ABSTRACT
Purpose: This study investigated the effects of power mobility training provided to exploratory power mobility learners with cerebral palsy (CP; Gross Motor Function Classification System Level V) on (1) parenting stress, (2) parents' perceptions of their children, and (3) children's attainment of power mobility skills. Method: A non-concurrent, multiple-baseline A-B single-subject research design study was conducted with three participants. The target behaviour was changes in the magnitude of parenting stress as measured by the Parenting Stress Index-Short Form. Parents' perceptions of their children were assessed using the Caregiver Priorities and Child Health Index of Life with Disabilities Questionnaire and a parent interview. Children's attainment of power mobility skills was assessed using the Canadian Occupational Performance Measure (COPM), the Assessment of Learning Powered mobility use, and the Wheelchair Skills Checklist. Power mobility training was provided twice a week for 8 weeks using an alternative power mobility device. Results: Positive and negative changes in both magnitude of parenting stress and parents' perceptions were identified post-intervention. All participants gained power mobility skills, assessed with the COPM. Conclusions: Power mobility training provided to exploratory power mobility learners with CP may influence levels of parenting stress.
Objectif : étude des effets de la formation à la mobilité motorisée offerte aux personnes ayant la paralysie cérébrale (PC niveau V du système de classification de la fonction motrice globale) sur 1) le stress lié aux pratiques parentales, 2) les perceptions qu'ont les parents de leur enfant et 3) les habiletés de mobilité motorisée acquises par les enfants. Méthodologie : plusieurs recherches à sujet unique A-B non concurrente et à niveau de base multiple auprès de trois participants. Ils ont ciblé des comportements de changements à la magnitude du stress lié aux pratiques parentales, mesurés par le formulaire court de l'indice de stress lié aux pratiques parentales. Pour évaluer les perceptions qu'ont les parents de leurs enfants, ils ont utilisé le questionnaire des priorités du proche aidant et de la santé de l'enfant selon l'indice de la vie avec des incapacités et fait une entrevue avec un parent. Ils ont également évalué les habiletés de mobilité motorisée acquises par les enfants au moyen de la mesure canadienne du rendement occupationnel (MCRO), de l'évaluation de l'apprentissage à utiliser la mobilité motorisée et de la liste des habiletés en fauteuil roulant. La formation à la mobilité motorisée a été offerte deux fois par semaine pendant huit semaines au moyen d'un autre appareil de mobilité motorisée. Résultats : les chercheurs ont déterminé les changements positifs et négatifs tant sur la magnitude du stress parental que sur les perceptions des parents après l'intervention. Tous les participants ont acquis des habiletés de mobilité motorisée, évaluées à l'aide de la MCRO. Conclusions : la formation à la mobilité motorisée qu'explorent les personnes ayant la PC peut influer sur les taux de stress lié aux pratiques parentales.
ABSTRACT
INTRODUCTION: Sports-related concussions (SRCs) have received attention due to their prevalence in youth. An SRC results from a strong force causing neurological impairment. Recent research has recommended rehabilitation within the first week post-SRC after 24 to 48 hours of rest. The postacute phase is defined as 48 hours to 7 days post-SRC. It is imperative to evaluate the most effective mode and intensity of physical activity to reduce symptoms and improve outcomes. METHODS: CINAHL, PubMed, SPORTDiscus, and Web of Science databases were used to search the terms "brain concussion" AND "exercise" and variations of these terms. The evidence level for each study was evaluated using the 2011 Oxford Center for Evidence-Based Medicine Guide. The methodological rigor of each study was evaluated using a scale adapted from Medlicott and Harris. RESULTS: Two thousand sixty-eight records were identified. Six studies were included in this systematic review. Three studies were classified as moderately strong. The remaining 3 studies were considered weak. Five of the studies used either a cycle ergometer or a treadmill. The sixth study used walking, cycling, and swimming, as well as sports drills. All of these modes of exercise were determined to be safe. All studies utilized low- and moderate-intensity interventions, which were found to be nondetrimental and showed improved recovery time and symptom resolution. Five of the studies also incorporated components of high-intensity exercise that was also found to be nondetrimental, and they showed a positive influence on recovery time and symptom resolution. However, all activity in each of the reviewed studies started at a low level and progressed up to a higher level only as each individual client's symptoms permitted. DISCUSSION: Overall, this review found that various modes of activity at light-, moderate-, and high-intensity levels are efficacious and can be safely used during the postacute phase of SRC. CONCLUSION: Though the volume of literature at this time is limited, therapists should consider prescribing closely monitored individualized exercise programs utilizing progressive intensities when treating patients during the postacute phase of SRC.
